Vol. 10, No. 1, March 1995 a New Direction in Population Policy And

Vol. 10, No. 1, March 1995 A New Direction in Population Policy and Family Planning in the Islamic Republic of Iran By Akbar Aghajanian The author of this article is Professor of Sociology, Fayetteville State University, Fayetteville, North Carolina, United States of America. An earlier version was presented as a paper at the 1994 Annual Meeting of the Middle East Association of America, Phoenix, Arizona, 19-24 November. The most important aspect of the new programme's success is the interest, support and guidance of religious leaders, and this holds many implications for other Muslim countries The birth control policy of the Islamic Republic of Iran can be traced back to 1967, from which time it continued to operate up to 1979. The policy was relaxed in 1979 following the establishment of the Islamic Republic but it was revived again in 1989. This article focuses on population policy changes and contraceptive use in the Islamic Republic of Iran since the establishment of the family planning programme in 1967. Before considering population policy and contraceptive use, an account of the country's population growth and change is presented. Figure 1 shows the size of the Iranian population since 1900. The population size for the years before 1956 are best estimates (Bharier, 1968). From 1956, the decennial censuses, which were carried out in 1956, 1966, 1976 and 1986, provide useful benchmark data from which can be observed demographic change in recent decades. The country's first modern census in 1956 recorded a population of 18.9 million. Twenty years later in 1976, a population of 34.3 million was counted, which increased to 49.5 million in 1986. The most recent data from a 1991 population survey revealed a population of 55.8 million. The 1994 ESCAP Population Data Sheet estimates a mid-year population of almost 64.9 million (ESCAP, 1994). Population growth was slow up until the end of the first quarter of the twentieth century. Bharier (1968) estimates that from 1900 to 1926 the average rate of population growth was less than 1 per cent per year. Apparently reflecting improvements in the standard of living, population growth doubled during the second quarter of the century. After the Second World War, the rate of population growth accelerated further, owing primarily to improvements in public health and notably to the eradication of malaria (Banani, 1961). Table 1 summarizes the changes in the indicators of population dynamics since 1966. Between 1966 and 1976, the country's population increased at an average annual rate of 2.7 per cent. This decreasing trend in the rate of population growth reflects a lowering of the birth rate as shown in table 1. The total fertility rate (TFR) declined from 7.7 to 6.3, a decline of almost one child per woman. In sum, during the late 1960s and early 1970s, the country had entered a new phase in its demographic transition, one characterized by the onset of fertility decline. Although the lowering of the birth rate at the national level was relatively moderate, a major drop in fertility in urban areas clearly signalled the potential for a broad-based fertility decline. Table 1: Population growth rate in the Islamic Republic of Iran, 1900-1986 Year Population (millions) Average annual growth rate (%) 1900 9.9 - 1927 12.0 0.8 1935 13.5 1.5 1941 14.8 1.5 1956 18.9 2.2 1966 25.7 3.1 1976 33.7 2.7 1986 49.4a 3.8b 1991 55.8 2.5c Source: Bharier, 1968; 1956-1986 rates are caculated from censuses. Notes: a Includes 1.8 million refugees from Afghanistan. b Growth rate calculated with the exclusion of 1.8 million refugees from Afghanistan is 3.4 per cent per year. c Rate of growth as calculated by the Iran Statistical Center. 1 During the decade 1976-1986, the size of the Iranian population increased from 33.7 million to 49.4 million (Iran Statistical Center, 1990). This implies an average annual growth rate of 3.8 per cent during the post- revolutionary era. This high rate of population growth is partially accounted for by the influx of 1.8 million refugees from Afghanistan between 1980 and 1986. However, analysis of the available data suggests a marked increase in the crude birth rate during the 1976-1986 period. TFR increased from 6.3 in 1976 to 7.0 in 1986 (Aghajanian, 1991b). Currently there is an indication that infant and child mortality continued to decline, especially during the 1980s. Infant mortality was estimated at about 112.4 per thousand live births during the period 1973-1976 (Iran Statistical Center, 1990). Estimates from the 1986 census reveal a rate of 88 per thousand by 1980 and a rate of 68 per thousand by 1986 (United Nations, 1992). It seems that the decline in infant mortality accelerated during the late 1980s. By 1992, an infant mortality rate of 43 per thousand births was reported (Population Reference Bureau, 1992). This is a decline of almost 60 per cent in infant mortality during the period 1976-1992. The increase in fertility and decline of infant mortality accelerated population growth during the period 1976-1986. Table 2: Population indicators in the Islamic Republic of Iran, 1966-1986 Indicators 1966 1976 1986 Population size (millions) 25.7 33.7 49.4 Crude birth rate 49.0 42.7 47.6 Total fertility rate 7.7 6.3 7.0 Although traditional methods of contraception, including "coitus interruptus", have been practised from the earliest times in what is now the Islamic Republic of Iran (Moore and others, 1974), modern contraceptives were first introduced in 1960 when the commercial sector was allowed to import oral contraceptives for the private market. After the results of the second National Population Census were announced in 1966, it became obvious to government officials that there was a crucial need for a family planning programme, since the situation concerned not only the health of mothers and children but also the socio-economic future of individual families and the country as a whole. The Council of Family Planning was established in the Ministry of Health in 1967; the official family planning programme was launched with the appointment of an under-secretary in the Ministry of Health. The aim of the programme was defined as the betterment and promotion of the physical, mental and socio- economic welfare of the family. The goal of the national policy was to increase health and welfare standards and to decrease the annual population growth rate. Later, during the Fifth Development Plan period (1973-1978), it was suggested that a national family planning programme would facilitate socio- economic growth through a reduction in the population growth rate from 3.1 per cent in 1971 to 2 per cent in 1978 (Plan and Budget Organization, 1973). Furthermore, Article 42 of the new penal code, passed by the Parliament on 16 June 1973, repealed restrictive abortion and sterilization laws. The new law, which was put into effect in November 1976, stated that "any type of medical or surgical procedure can be performed by a recognized physician with agreement of those who have the right to consent to the procedure in accordance with rules and regulations approved by the Government". This law created a loophole for carrying out induced abortions. In addition, university and high school curricula were permitted to include family planning information and population education (Nortman and Hofstatter, 1978). Therefore, the Government's attitude towards family planning changed from the stage, during the early 1960s, of enabling family planning choice and decision- making and making contraceptives available through the commercial sector to a stage in the later years of the 1960s and early 1970s characterized by active government concern about family welfare and the distribution of contraceptives through public clinics. The third stage of the aggressive programme involved a huge mass media campaign to promote family planning, as concern over the adverse effects of population growth on national economic growth heightened in the mid-1970s. However, by 1977, at the peak of the promotion of family planning activities, only 11 per cent of eligible women were using contraceptives (Aghajanian, 1989). 1979-present The Islamic Republic of Iran did not consider population growth as a problem following its establishment in 1979, when population as a policy matter was dropped from the Government's agenda. The Family Planning Council of Iran was dissolved and the Government of the Islamic Republic of Iran officially discontinued the existing fertility control policy. Although Ayatollah Ruhollah Khomeini's fatva (direction) approved of birth control as long as it (a) does not hurt mothers and children and (b) excludes abortion, many family planning clinics which had been operating independently of the Department of Health were closed. In the Department of Health, family planning services were provided within the Family and School 2 Health Clinics, which had several other tasks besides the provision of family planning services alone. Further, as time passed, when contraceptive supplies ran out they were not replaced. Following the end of armed conflict with Iraq, official views about population size changed in light of the short-term and long- term problems that loomed vis-a-vis a rapidly growing population. The Government was then faced with a large population demanding food, health services, education and employment. In February 1988, for the first time, the Prime Minister issued a statement to members of the Cabinet regarding the topic of population as an issue. In March of that year, a committee was organized in the Ministry of Plan and Budget, consisting mostly of economists in the Ministry and a few demographers from universities.

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